Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dian-mian Avenue, Wuhua District, Kunming, 650101, China.
Department of PET Center, Taihe Hospital, Hubei University of Medicine, Shiyan, China.
J Cardiothorac Surg. 2022 Dec 22;17(1):332. doi: 10.1186/s13019-022-02072-6.
The characteristics are still unclear due to lack of systematic research on patients with myocardial infarction non-obstructive coronary arteries (MINOCA) in China. This study aimed to explore the clinical and imaging features of MINOCA patients.
The patients who were diagnosed as suspected MI were studied. Cardiac magnetic resonance (CMR) was performed after coronary angiography or coronary computed tomographic angiography examination within one week. Myocardial infarction (MI) was determined by late gadolinium enhancement CMR.The patients with MI were divided into MINOCA and MICAD group according to whether the degree of coronary stenosis was greater than 50%. Cardiac function and imaging characteristics between the two groups were analyzed.
21 patients with MINOCA and 30 patients with myocardial infarction with obstructive coronary artery disease (MICAD) were analyzed. MINOCA patients were younger, and the electrocardiogram was commonly featured by non-ST-elevation. The parameters of left ventricular function were significantly different between the two groups including left ventricular ejection fraction, stroke volume, cardiac output, myocardial mass, and peak ejection rate (P < 0.05). Besides, MINOCA patients had smaller area of MI, less score of transmural extent, fewer involved segments. Furthermore, the transmural extent of MI in MINOCA patients was mainly grade I, that is, most of them were subendocardial MI, which was significantly negatively correlated with the amount of first-pass perfusion.
The clinical characteristics combined with imaging features of CMR may be effective to evaluate the cardiac function in order to make clinical decision for MINOCA patients in China.
由于缺乏对中国非阻塞性冠状动脉心肌梗死（MINOCA）患者的系统研究，其特征尚不清楚。本研究旨在探讨 MINOCA 患者的临床和影像学特征。
研究了经冠状动脉造影或冠状动脉计算机断层血管造影检查后 1 周内疑似 MI 的患者。通过心脏磁共振（CMR）检查确定心肌梗死（MI），用钆延迟增强 CMR 来判断。根据冠状动脉狭窄程度是否大于 50%，将 MI 患者分为 MINOCA 和 MICAD 组。分析两组患者的心功能和影像学特征。
分析了 21 例 MINOCA 和 30 例有阻塞性冠状动脉疾病的心肌梗死（MICAD）患者。MINOCA 患者更年轻，心电图常见非 ST 段抬高。左心室功能参数在两组间有明显差异，包括左心室射血分数、每搏量、心输出量、心肌质量和射血峰值速率（P < 0.05）。此外，MINOCA 患者的 MI 面积较小，透壁程度评分较低，累及节段较少。此外，MINOCA 患者的 MI 透壁程度主要为 I 级，即大部分为心内膜下 MI，与首过灌注量呈显著负相关。
CMR 的临床特征结合影像学特征可能有助于评估心功能，从而为中国 MINOCA 患者做出临床决策。
